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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Dec 2 • 5 tweets • 3 min read
Shorter #stride length is associated with higher incidence of life threatening clinical events in #olderadults
1. 14,000 people (Av age 75 yrs) were followed up for 33 months. 10% of them sustained #Falls. Stride length was shorter in fallers as compared to non-fallers. Image
2. In a sub-analysis based on gender, the stride length was longer and #walking speed slower in males compared to females.

#running #fitness #healthylifestyle
3. Major adverse events (MAEs) were 36% higher, physical disability 26% higher and #mortality 69% higher in older people with shorter stride length.
MAEs included physical disability, falls, dependency, institutionalization, and mortality.
#MedTwitter
4. A short stride length of ≤0.64 meter accurately predicted clinical events, over and above other gait measures.
5. Take home message-
Higher gait speed has been shown to be associated with better survival among older adults.
Longer stride length is also associated with better health-related outcomes (lesser falls, disability and #deaths).
Reference
doi.org/10.3390%2Fjcm1…

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 4
Food myth busted: Potato is not bad for diabetics

1. Potato has got a bad name, and diabetics are advised to avoid it because of its high glycemic index. However, findings of a recent research busts this myth.

#nutrition #healthyfood #diet #MedTwitter #diabetes #weightloss
2. This was an 8-week randomized, controlled feeding study comparing Potato and Bean diets (50-55% carbohydrate, 30-35% fat, 15-20% protein).
Thirty-six participants (18-60 years, BMI: 25-40 kg/m2) with insulin resistance were enrolled.
Ref: doi.org/10.1089/jmf.20…
3. Among study completers, HOMA-Insulin resistance in the bean group showed an average decrease of 1.4 from baseline (P = .02 ); a similar decrease of 1.3 occurred in the potato group (P < .05) with no significant difference between the two diets.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 4
Painful muscle cramping in runners- why do they occur and how to manage them?
1.Many runners have experienced cramps (involuntary painful muscle contractions). Besides pain, it can derail one’s aim for the personal best; in worst cases, runner is unable to even complete the run.
2. Common muscles affected- Cramps usually affect calves, hamstrings and glutei, but other muscles too can get affected.
#runner #running #cramps
3. Risk factors for cramps-Long distance running (> 30 km), presence of fatigue, running at a pace faster than that of training pace; age>40, longer history of running, higher BMI, shorter daily stretching time, irregular stretching habits, training <3 times/week, family history
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 3
Lesser night #sleep and daytime #napping increases the risk of inflammatory bowel disease (#IBD)

1. 4,88,000 people aged 40-69 were followed up for 12 years. 1 in 200 (0.5%) were diagnosed to have IBD. 31% had Crohn's disease, 69% ulcerative colitis
#MedTwitter #Gastroenterology
2. Compared with participants with a sleep duration of 7 hours/day, those with a sleep duration of ≤5 hours/day had a higher risk of:
Inflammatory bowel disease: 36% higher
Crohn's disease: 53% higher
Ulcerative colitis: 29% higher
3. Compared with participants without daytime napping, those with daytime napping had a higher risk of:
Inflammatory bowel disease: 13% higher
Crohn's disease: 25% higher
Ulcerative colitis: 9% higher
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 1
"Retirement" from work as a risk factor for #Dementia: experience of 5 recent patients

1. I saw 5 new cases of dementia last month, which apparently started within 6 to 18 months after retirement from work. All were cognitively normal until retirement.

#MedTwitter #Alzheimer
2. Memory impairment was the most prominent symptom. Over a period of time, other symptoms such as impaired calculation, speech impairment, losing sense of direction, poor judgement and inability to do daily activities without assistance, also started. Symptoms were progressive.
3. A diagnosis of Alzheimer's disease was made on the basis of detailed neuro-psychological assessment, brain scans and other appropriate investigations.
Two patients had comorbid #depression. Three patients had #sleep disorders- two had #insomnia and one had excessive sleep.
Read 10 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 1
#Valproate (VPT) is still more efficacious and more cost-effective as compared to #levetiracetam (LEV) for treating generalized #Epilepsy (GE)

1. I see an increasing trend for prescribing LEV in emergency room, ICU & OPD for GE
#MedTwitter #neurotwitter

doi.org/10.1016%2FS014…
2. In a recent study, LEV was found to be inferior for times to treatment failure, 2-year remission from seizures, and first subsequent seizure. In addition, LEV was not found to be a cost-effective alternative.
3. This is despite the fact the LEV is associated with a higher incidence of #psychiatric and #behavioral adverse effects.
This is a major problem in #ICU patients, as it adds to the burden of patients with #psychosis in ICU.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Nov 29
#eyes becoming smaller in evenings could be a sign of #neurological illness

1. I was seeing the last patient, on what had been a busy Monday. While counselling the patient's attendant (aged 45), I noticed that her left eye was smaller than the right.

#MedTwitter #neurotwitter
2. On enquiry, she confirmed that her eyes were of equal size in mornings, but left eye became smaller as the day progressed. This was the case for the past 4-5 months. She had no other issues. This had been noted by her family members and friends too. An eye check up was normal.
3. I discussed with her that this could be a sign of #myasthenia gravis (MG) and asked for investigations. Repetitive nerve stimulation was normal. However, acetylcholine receptor antibody was high (8; normal value<0.25). The diagnosis of MG was confirmed. CT chest was normal.
Read 9 tweets

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